RESUME

M. SANTHOSH. CPC, ICD-10 CM.

Dubai.

Mail-Id      :       [email protected]

Phone No. :        +971-525849594

Objective:
To pursue a challenging and rewarding career that would enhance my technical and interpersonal skills and provide opportunities for personal and professional growth.

Experience Summary:
Ø  Overall 11 yrs. of experience in Medical Coding & Insurance industry and currently working as a Sr. Medical Coder in International Modern Hospital, Dubai.

Ø  Currently Working on IP-DRG (IR DRG-UAE).

Ø  Well experienced in CPT4, ICD-10 CM, ICD-9 CM, HCPCS, ICD-10 PCS and Modifiers.

Ø  Well experienced in Australia coding ICD 10 AM, ACHI codes, ACS.

Ø  Worked on NHI (SEHA) coding/claims submissions, rejections, and resubmissions.

Ø  Experienced in US, Australia, UAE coding.

Ø  Experienced in Team Handling.

Areas of expertise in various specialties.

Ø  Experienced in IP-DRG (MS DRG, IR DRG, AR DRG) coding.

Ø  Experienced in E/M (In Patient, Out Patient, ED) coding.

Ø  Experienced in Surgery coding.

Ø  Experienced in Interventional Radiology (IVR) and Diagnostic Radiology coding.

Ø  Experienced in HCC coding.

Ø  Experienced in Denial management.

Ø  Experienced in Insurance approvals.

Ø  Worked as a Medical Coding Trainer.

Ø  Experienced in coding all specialty charts with good quality and productivity.

Ø  Experienced in Quality Auditing of all specialties.

Ø  Well versed in Medical Terminology and Anatomy.

Ø  Computer and medical knowledge, strong organizational abilities, demonstrating quality and communication skills.

Ø  With an excellent record meeting and exceeding all performance goals.

Professional experience:

Current Organization: 5:

Company          :           lnternational Modern Hospital, Dubai.

Designation    :       Sr. Medical Coder.
Duration           :           October 2017 – Present.

Previous Organization: 4:

Company          :           Al Ahli Hospital, Doha, Qatar.

Designation    :       Coding Specialist, Team Coordinator-Coding.
Duration           :           August 2014 – November 2016.

Previous Organization: 3:

Company          :           United Health Group Pvt. Ltd, Hyderabad, India.

Designation    :       SME (Sr. Coding Specialist).
Duration           :           July 2013 – August 2014.

Previous Organization: 2:

Company          :           E4E Health care Business. Chennai, India.

Designation    :       Coding Quality Auditor.
Duration           :           January 2013 – May 2013.

Previous Organization: 1:

Company          :           Apollo Health Street Pvt. Ltd, Hyderabad, India.

Designation    :       Sr. Coder & Auditor.
Role            :       Quality Auditor.
Duration           :           January 2008 – Dec 2012.

Roles & Responsibilities:
Ø  Managing coding operations to deliver services as per client SLA’s.

Ø  Presenting project performance through weekly and monthly review meetings with

leadership team.

Ø  Current KRA’s includes meeting client SLA, vendor Management, Resource utilization

and focus on top line overall efficiency.

Ø  Managing service delivery goals through daily and weekly client calls and maintaining

good client relationship.

Ø  Monitoring of team’s performance & progress through daily reports, team meetings.

Ø  Conducting TLs meeting on daily basis to get the review and feedback on their

individual team performances.

Ø  At the end of the day compile the entire Team production, quality reports and publish to the Management.

Ø  Extraction of the charts from client pool and allocating to teams on daily basis.

Ø  Actively participated in Pilot projects.

Ø  Monitoring coder’s production and quality on daily basis.

Ø  Encouraging coders and TL’s to meet their individual and team, production and quality

targets.

Ø  Conducting weekly sessions on client CPT, ICD 10 cm new updates.

Ø  Responsible for training & continuous improvement on Coding industry changes and

various refreshment trainings.

Ø  Actively conducting coding training sessions to the new coders on client specific

guidelines, conducting weekly mock tests.

Ø  Preparation of coding documentation.

Ø  Provides individual feedback to coders based on their quality to enhance their skill

level as well as providing opportunities for advancement in the coding section.

Ø  Researches, analyzes and responds to inquiries regarding compliance, inappropriate

coding, denials and billable services.

Ø  Weekly and Daily team huddles to update the new coding updates and daily plan

activity.

Ø  Handling the Insurance approvals end to end process.

Professional Qualification:
Ø  CPC from AAPC (American Academy of Professional Coders).

Ø  ICD 10-CM Proficiency certified.

Ø  Trained in ICD-10AM, ACS, ACHI codes(Australia coding)

Ø  Six Sigma – White Belt.

Educational background:
Ø  Bachelor of Science from Kakatiya University in the year of 2004 – 2007.

Technical Skills:
Ø  Coding Applications     :           CITRIX, 3M, Alife, E-hope, CareHIS.

Ø  Operating System         :           Windows 10, MS-office

Personal Details:
Name                                       :           M. Santhosh.

Marital Status                             :            Married.

Nationality                                :           Indian.

Languages known                     :           English, Telugu, Hindi, Tamil.

Declaration:
I hereby that the above written particulars are true to the best of my knowledge and belief.

Place    :   Dubai.

Date     :                                                                                                     (M. Santhosh.)